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In January 2005, a tetravalent meningococcal polysaccharide-protein conjugate vaccine ([MCV4]
Menactra®, manufactured by Sanofi Pasteur, Inc., Swiftwater, Pennsylvania), was licensed for use among persons aged 11--55 years. The Advisory
Committee on Immunization Practices (ACIP) recommends routine vaccination with MCV4 of persons aged 11--12 years, of adolescents
at high school entry (i.e., at approximately age 15
years) if not previously vaccinated with MCV4, and of college freshmen living
in dormitories. Vaccination also is recommended for other persons at increased risk for meningococcal disease (i.e., military
recruits, travelers to areas where meningococcal disease is hyperendemic or epidemic, microbiologists who are routinely exposed to
isolates of Neisseria meningitidis, persons with anatomic or functional asplenia,
and persons with terminal complement deficiency)
(1).

Sanofi Pasteur anticipates that MCV4 demand will outpace supply at least through summer 2006. CDC, in
consultation with ACIP, the American Academy of Pediatrics, American Academy of Family Physicians, American College
Health Association, and Society for Adolescent Medicine, recommends that providers continue to vaccinate adolescents at high
school entry who have not previously received MCV4 and college freshmen living in dormitories. Current supply projections
from Sanofi Pasteur suggest that enough MCV4 will be available to meet vaccine demand for these groups. Until further
notice, administration of MCV4 to persons aged
11--12 years should be deferred. If possible, providers should track persons aged
11--12 years for whom MCV4 has been deferred and recall them for vaccination when supply improves. Other persons at
high risk for meningococcal disease (i.e., military recruits, travelers to areas where meningococcal disease is
hyperendemic or epidemic, microbiologists who are routinely exposed to isolates of
N. meningitidis, persons with anatomic or
functional asplenia, and persons with terminal complement deficiency) also should be vaccinated.

For vaccination of most persons, MCV4 is preferable to tetravalent meningococcal polysaccharide vaccine
([MPSV4] Menomune®-A,C,Y,W-135, manufactured by Sanofi Pasteur). MPSV4 is highly effective in preventing meningococcal
disease caused by serogroups A, C, Y, and W-135 and is an
acceptable alternative to MCV4, particularly in persons who have
brief elevations in their risk for meningococcal disease (e.g., travelers to areas where meningococcal disease is hyperendemic
or epidemic); however, availability of MPSV4 also is limited.

Reference

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